Screening for prostate cancer—checking for signs of the disease when there are no symptoms—is done with the prostate-specific antigen (PSA) test. In the United States, about 12 out of 100 men will be diagnosed with prostate cancer sometime during their lifetime.footnote 1 But most men who are diagnosed with prostate cancer don't die from prostate cancer.
Deciding whether to get PSA testing can be hard. Few, if any men, are helped to live longer by having the test. Depending on your age and risk, it may be helpful or it may be harmful.
Many prostate cancers grow so slowly that they will never cause a problem and are not life-threatening. Fast-growing, more dangerous types of prostate cancer occur less often. The test can help find prostate cancer early. Treatment may help some men with fast-growing cancers live longer. But treatment can cause problems, such as leaking urine or not being able to have an erection. If cancer is found, it isn't clear if the cancer will turn out to be a rare, life-threatening case, so men often get unnecessary treatment.
Before you decide to have a PSA test, talk with your doctor. Ask about your risk for prostate cancer, and discuss the pros and cons of testing. Some men will not want to live with the side effects of treatment. Other men are more concerned about survival. It is important to learn all you can and talk to your doctor before making a decision.
Experts have set up guidelines to advise men about prostate cancer screening.
These guidelines are based on a man's age and his risk of getting prostate cancer. Some things that put men at a higher risk include:
- Being African American.
- Having a father or brother who had prostate cancer before age 65.
- Knowing that a gene change, such as BRCA, runs in your family.
Most experts agree on the following age-related recommendations.
Age 40 and under:
- Men aren't advised to get the PSA test, since testing in this age group causes more harm than good.
Age 40 to 54 years:
- Men at average risk aren't advised to get the PSA test, since testing in this age group causes more harm than good.
- Around age 45, men at higher risk may want to talk with their doctors about the pros and cons of testing before deciding whether to get the PSA test.
Age 55 to 69 years:
- Men who are thinking about getting the PSA test are advised to talk with their doctors about the pros and cons of testing before deciding whether to get the PSA test.
Ages 70 and older:
- Most men aren't advised to get the PSA test, since testing in this age group causes more harm than good.
Evidence suggests that if a man chooses to get the PSA test on a regular basis, having it every 2 (or more) years may be better than having it every year. This appears to reduce his risk of harm from having the test.
For more information, see the topic Prostate Cancer.
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Current as of: August 21, 2019
Author: Healthwise Staff
Medical Review: E. Gregory Thompson MD - Internal Medicine
Kathleen Romito MD - Family Medicine
Christopher G. Wood MD, FACS - Urology, Oncology
Current as of: August 21, 2019